MEDICARE: MINDNAUTILUS.COM CORPORATION DBA ENABLEMART

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1801049663
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MINDNAUTILUS.COM CORPORATION DBA ENABLEMART

Provider Business Mailing Address
First Line	:	5353 S 960 E STE 200
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84117-3576
Country	:	US
Telephone Number	:	801-281-7677
Fax Number	:

Provider Business Practice Location Address
First Line	:	5353 S 960 E STE 200
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84117-3576
Country	:	US
Telephone Number	:	801-281-7677
Fax Number	:

Authorized Official
Title or Position	:	ACCOUNTS RECEIVABLE
Name	:	MS. ISABEL PARKIN
Credential	:
Telephone Number	:	801-281-7677

Provider Enumeration Date	:	10/24/2008
Last Update Date	:	10/24/2008

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